April 2012

Internists are piecing together technology to improve their practice management, but
too many pieces are more of a puzzle than a picture. All the new devices ultimately
need to lead to better care, the experts urge.

Dabigatran and rivaroxaban spare patients the need for regular blood checks, but warfarin
is less expensive and has an antidote to reverse bleeding, if needed. Does the convenience
of the new generation of drugs and the potential to increase compliance with therapy
outweigh their downsides?.

If your idea of a stimulating vacation involves unsafe destinations, bribing foreign
officials for a medical license and practicing resource-limited hospitals, then there's
an organization willing to set it all up for you. (You also get to meet kings and
see beautiful scenery.).

A 73-year-old man struggles with the decision whether to consider anticoagulation
for atrial fibrillation, a “decisional conflict” that affects many trying
to balance risks and rewards of medical treatments. Doctors should help the patients
choose, but then abide by that decision.

Health care reform has made progress with internists already seeing bonus reimbursement
in their offices. But the Affordable Care Act is about to run smack into the Supreme
Court, and what happens there could result in any range of outcomes.

The Centers for Medicare and Medicaid Services heard the primary care community's
complaints and have delayed ICD-10 implementation until further notice. The agency
did, however, launch several new tactics in order to collect overpayments.

Once a practice receives pay-for-performance bonuses, how should they be distributed?
Do they go to the treating physicians, the entire practice or some kind of hybrid?
There options aplenty to consider.

Chapters honor Members, Fellows, and Masters of ACP who have demonstrated by their
example and conduct an abiding commitment to excellence in medical care, education,
research, or service to their community, their chapter, and ACP.

A 34-year-old woman is evaluated for sharp intermittent pleuritic chest pain that
has persisted for 1 week. The pain is worse when she lies down in the supine position.
She has had no fever, chills, cough, or weight loss. She had acute viral pericarditis
6 months ago that was treated initially with ibuprofen, but when she failed to respond
after 3 days, a 10-day tapering dosage of prednisone was instituted, leading to resolution
of clinical symptoms.

Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. ACP Internist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated.